Critical appraisal:Bhat S, Coleman HG, Yousef F, Johnston BT, McManus DT, Gavin AT, et al 2011 5

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Critical Appraisal

Article being appraised

Bhat S, Coleman HG, Yousef F, Johnston BT, McManus DT, Gavin AT, et al. Risk of malignant progression in Barrett's esophagus patients: results from a large population-based study. J Natl Cancer Inst 2011 Jul 6;103(13):1049-57 Available from: http://www.ncbi.nlm.nih.gov/pubmed/21680910.


Applicable clinical question

Key Facts

Study Design

cohort study

Number of Patients:

8522


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
Low risk of bias Comments: Large prospective Northern Irish cohort prospective study examing incidence of HGD or adenoca in cohort of BO patienst and factors associated with increased risk of progression.

Risk of bias assessment: cohort study

Subject selection
"New technology" group
Representative of eligible patients.
Comparison group
Representative of eligible patients
Comparability of groups on demographic characteristics and clinical features
Comparable
Measurement of outcomes
Outcome measures blind to technology used
Yes
Same method of measurement used across comparison groups
Yes
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
Yes (follow-up >95%) or survival analysis using all patients
Size of effect
1 Reason for decision: Significantly greater risk of cancer in those with IM cf those without ( HR 3.54, 95% CI 2.09 - 6.00), men cf women (HR 2.11, 95%CI 1.41-3.16) and LGD cf no dysplasis (HR 5.67, 95%CI 3.77-8.53)
Relevance of evidence
1 Additional comments: Highly relevant patient outcome of HGD and adenocarcinoma of the oeosophagus.
Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Bradley Kendall MBBS, FRACP


Jutta's tick icon.png This appraisal has been completed.


Article
Bhat S, Coleman HG, Yousef F, Johnston BT, McManus DT, Gavin AT, et al. Risk of malignant progression in Barrett's esophagus patients: results from a large population-based study. J Natl Cancer Inst 2011 Jul 6;103(13):1049-57 Available from: http://www.ncbi.nlm.nih.gov/pubmed/21680910.
Assigned to
User:Brad.kendall
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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